EP2688871B1 - Prodrugs of lxr modulating imidazole derivatives - Google Patents

Prodrugs of lxr modulating imidazole derivatives Download PDF

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EP2688871B1
EP2688871B1 EP12711739.8A EP12711739A EP2688871B1 EP 2688871 B1 EP2688871 B1 EP 2688871B1 EP 12711739 A EP12711739 A EP 12711739A EP 2688871 B1 EP2688871 B1 EP 2688871B1
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compound
pharmaceutically acceptable
compounds
acceptable salt
disease
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EP2688871A1 (en
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Ellen K. Kick
Michael J. Hageman
Victor R. Guarino
Ching-Chiang Su
Chenkou Wei
Jayakumar Sankara WARRIER
Satheesh Kesavan NAIR
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Bristol Myers Squibb Co
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    • C07ORGANIC CHEMISTRY
    • C07DHETEROCYCLIC COMPOUNDS
    • C07D233/00Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, not condensed with other rings
    • C07D233/54Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, not condensed with other rings having two double bonds between ring members or between ring members and non-ring members
    • C07D233/64Heterocyclic compounds containing 1,3-diazole or hydrogenated 1,3-diazole rings, not condensed with other rings having two double bonds between ring members or between ring members and non-ring members with substituted hydrocarbon radicals attached to ring carbon atoms, e.g. histidine
    • AHUMAN NECESSITIES
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    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
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    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/41Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having five-membered rings with two or more ring hetero atoms, at least one of which being nitrogen, e.g. tetrazole
    • A61K31/41641,3-Diazoles
    • A61K31/4174Arylalkylimidazoles, e.g. oxymetazolin, naphazoline, miconazole
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    • C07F9/00Compounds containing elements of Groups 5 or 15 of the Periodic Table
    • C07F9/02Phosphorus compounds
    • C07F9/06Phosphorus compounds without P—C bonds
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    • C07F9/00Compounds containing elements of Groups 5 or 15 of the Periodic Table
    • C07F9/02Phosphorus compounds
    • C07F9/547Heterocyclic compounds, e.g. containing phosphorus as a ring hetero atom
    • C07F9/645Heterocyclic compounds, e.g. containing phosphorus as a ring hetero atom having two nitrogen atoms as the only ring hetero atoms
    • C07F9/6503Five-membered rings
    • C07F9/6506Five-membered rings having the nitrogen atoms in positions 1 and 3

Definitions

  • the present invention provides for prodrug imidazole compounds useful as modulators of nuclear receptors, including liver X receptor (LXR), and to pharmaceutical compositions containing such compounds.
  • LXR liver X receptor
  • the present invention further provides such compounds for use in the treatment and prevention of diseases or disorders mediated by nuclear receptor activity, including LXR and/or orphan nuclear receptor activity.
  • Nuclear receptors are a superfamily of regulatory proteins that are structurally and functionally related and are receptors for, e.g., steroids, retinoids, vitamin D and thyroid hormones (see, e.g., Evans, Science, 240:889-895 (1988 )). These proteins bind to cis -acting elements in the promoters of their target genes and modulate gene expression in response to ligands for the receptors.
  • Nuclear receptors can be classified based on their DNA binding properties (see, e.g., Evans, supra, and Glass, Endocr. Rev., 15:391-407 (1994 )).
  • one class of nuclear receptors includes the glucocorticoid, estrogen, androgen, progestin and mineralocorticoid receptors which bind as homodimers to hormone response elements (HREs) organized as inverted repeats (see, e.g., Glass, supra ).
  • HREs hormone response elements
  • a second class of receptors including those activated by retinoic acid, thyroid hormone, vitamin D 3 , fatty acids/peroxisome proliferators (i.e., peroxisome proliferator activated receptors or PPARs) and ecdysone, bind to HREs as heterodimers with a common partner, the retinoid X receptors (i.e., RXRs, also known as the 9- cis retinoic acid receptors; see, e.g., Levin et al., Nature, 355:359-361 (1992 ) and Heyman et al., Cell, 68:397-406 (1992 )).
  • RXRs also known as the 9- cis retinoic acid receptors
  • RXRs are unique among the nuclear receptors in that they bind DNA as a homodimer and are required as a heterodimeric partner for a number of additional nuclear receptors to bind DNA (see, e.g., Mangelsdorf et al., Cell, 83:841-850 (1995 )).
  • the latter receptors termed the class II nuclear receptor subfamily, include many which are established or implicated as important regulators of gene expression.
  • RXR genes there are three RXR genes (see, e.g., Mangelsdorf et al., Genes Dev., 6:329-344 (1992 )), coding for RXRa, - ⁇ , and - ⁇ , all of which are able to heterodimerize with any of the class II receptors, although there appear to be preferences for distinct RXR subtypes by partner receptors in vivo ( see , e.g., Chiba et al., Mol. Cell. Biol., 17:3013-3020 (1997 )).
  • RXR ⁇ is the most abundant of the three RXRs (see, e.g., Mangelsdorf et al., Genes Dev., 6:329-344 (1992 )), suggesting that it might have a prominent role in hepatic functions that involve regulation by class II nuclear receptors. See also, Wan et al., Mol. Cell. Biol., 20:4436-4444 (2000 ).
  • LXR ⁇ is found predominantly in the liver, with lower levels found in kidney, intestine, spleen and adrenal tissue (see, e.g., Willy et al., Genes Dev., 9(9):1033-1045 (1995 )). LXR ⁇ is ubiquitous in mammals and was found in nearly all tissues examined. LXRs are activated by certain naturally occurring, oxidized derivatives of cholesterol ( see , e.g., Lehmann et al., J. Biol. Chem., 272(6):3137-3140 (1997 )). LXR ⁇ is activated by oxycholesterol and promotes cholesterol metabolism ( Peet et al., Cell, 93:693-704 (1998 )). Thus, LXRs appear to play a role in, e.g., cholesterol metabolism ( see, e.g., Janowski et al., Nature, 383:728-731 (1996 )).
  • the nuclear receptor LXR plays a critical role in coordinate control of bile acid, cholesterol, and triglyceride metabolism to maintain lipid homeostasis.
  • LXRs and bile acid/oxysterol-regulated genes are potential targets for developing drug therapies for lowering serum cholesterol and treating cardiovascular and liver diseases.
  • Compounds with activity at LXR can have profound effects on lipid homeostasis, and can more effectively control disease or disorders in which LXR is implicated. This is accomplished through regulation of multiple genes involved in cholesterol homeostasis including Cyp7a1, a member of the cytochrome p450 family of enzymes and the rate limiting step in bile acid synthesis, as well as the ABC membrane transporters ABCA1, ABCG1, ABCG5, and ABCG8.
  • ABCA1 is critical in the efflux of cholesterol and phospholipids to lipid-poor lipoproteins such as ApoA-I thus contributing to an increase in plasma HDL levels.
  • ABCG5 and ABCG8 appear to mediate decreased intestinal absorption of cholesterol and facilitate cholesterol efflux from liver cells into the bile.
  • LXR agonists increase plasma triglyceride levels and hepatic lipogenesis and promote the increased production of VLDL lipoprotein particles.
  • LXR ⁇ selective compounds that are also partial agonists. Partial agonists can display tissue-specific activation or repression of nuclear receptors, as was demonstrated for the anti-estrogen tamoxifen, which functions as an antagonist of estrogen signaling in breast tissue and an agonist in the uterus. Characterization of LXR isoform-specific null mice indicate that LXR ⁇ is the predominant mediator of LXR activity in the liver. In macrophages, however, LXR ⁇ alone is sufficient to mediate the effects of LXR ligands on target gene expression. Therefore compounds with limited LXR ⁇ activity should have anti-atherogenic activity while limiting unwanted hepatic effects.
  • Nuclear receptor activity has been implicated in a variety of diseases and disorders, including, but not limited to, hypercholesterolemia (see, e.g., PCT Publication No. WO 00/57915 ), osteoporosis and vitamin deficiency (see, e.g., U.S. Patent No. 6,316,503 ), hyperlipoproteinemia ( see , e.g., PCT Publication No. WO 01/60818 ), hypertriglyceridemia, lipodystrophy, hyperglycemia and diabetes mellitus (see, e.g., PCT Publication No. WO 01/82917 ), atherosclerosis and gallstones (see, e.g., PCT Publication No.
  • WO 00/37077 disorders of the skin and mucous membranes (see, e.g., U.S. Patent Nos. 6,184,215 and 6,187,814 , and PCT Publication No. WO 98/32444 ), acne ( see , e.g., PCT Publication No. WO 00/49992 ), and cancer, Parkinson's disease and Alzheimer's disease (see, e.g., PCT Publication No. WO 00/17334 ).
  • the present invention comprises compounds or an isotope or a pharmaceutically acceptable salt thereof, which are useful as modulators of the activity of liver X receptors (LXRs).
  • LXRs liver X receptors
  • compounds of the invention are prodrugs of compounds that are useful for modulating the liver X receptors, LXR ⁇ and LXR ⁇ , and in particular, LXR ⁇ .
  • compounds of the present invention show unexpected advantages over compounds previously disclosed in the art, such as those disclosed in PCT Publication No. WO 2010/138598 .
  • the present prodrug compounds have been shown to have a desirable pH dependent absorption and therefore improved bioavailability of the parent compound.
  • the compounds of the present invention have been shown to increase the bioavailability of 2-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-1-(3,3'-difluoro-4'-(hydroxymethyl)-5'-(methylsulfonyl)-4-biphenylyl)-1 H -imidazol-4-yl)-2-propanol at elevated gastric pH (e.g., pH 7), for example, in dogs treated with famotidine.
  • elevated gastric pH e.g., pH 7
  • Such compounds should be more useful in the treatment, inhibition or amelioration of one or more diseases or disorders that are discussed herein.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in treating, inhibiting, or ameliorating the symptoms of a disease or disorder that is modulated or otherwise affected by LXR activity or in which LXR activity is implicated.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in modulating cholesterol metabolism to a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in preventing or treating atherosclerosis in a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in modulating LXR activity to a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in treating, inhibiting or ameliorating one or more symptoms of hypocholesterolemia in a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in increasing cholesterol efflux from cells of a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in increasing the expression of ATP-Binding Cassette A1 (ABCA1) and ATP-Binding Cassette G1 (ABCG1) in the cells of a subject in need thereof.
  • ABCA1 ATP-Binding Cassette A1
  • ABCG1 ATP-Binding Cassette G1
  • Another embodiment of this invention is directed to a compound of the present invention a pharmaceutically acceptable salt thereof, for use in treating, inhibiting, or ameliorating one or more symptoms of a disease or disorder which is affected by cholesterol or bile acid levels.
  • Another embodiment of this invention is directed to pharmaceutical compositions comprising a compound of the present invention or a pharmaceutically acceptable salt thereof and at least one pharmaceutically acceptable carrier or excipient.
  • compositions comprising a compound of the present invention or a pharmaceutically acceptable salt thereof and at least one additional therapeutic agent.
  • at least one other anti-arrhythmic agent such as sotalol, dofetilide, diltiazem or Verapamil
  • at least one calcium channel blocker or at least one anti-platelet agent (such as clopidogrel, cangrelor, ticlopidine, CS-747, ifetroban and aspirin)
  • at least one anti-hypertensive agent such as a beta adrenergic blocker, ACE inhibitor (e.g., captopril, zofenopril, fosinopril, enalapril, ceranopril, cilazopril, delapril, pentopril, quinapril, ramipril, or lisinopril)
  • a II antagonist such as sotalol, dofetilide, diltiazem or Verapamil
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in the regulation of reverse cholesterol transport and inflammatory signaling pathways that are implicated in human disease pathology including atherosclerosis and associated diseases such as myocardial infarction and ischemic stroke in a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof, for use in the treatment of the metabolic syndrome which comprises a constellation of disorders of the body's metabolism including obesity, macular degeneration, hypertension, insulin resistance, and diabetes including treatment of diseases resulting from compromised metabolism and immunity including atherosclerosis and diabetes as well as autoimmune disorders and diseases in a subject in need thereof.
  • the metabolic syndrome which comprises a constellation of disorders of the body's metabolism including obesity, macular degeneration, hypertension, insulin resistance, and diabetes including treatment of diseases resulting from compromised metabolism and immunity including atherosclerosis and diabetes as well as autoimmune disorders and diseases in a subject in need thereof.
  • Another embodiment of this invention is directed to a compound of the present invention or a pharmaceutically acceptable salt thereof for use in the treatment of the atherosclerosis, insulin resistance, osteoarthritis, stroke, hyperglycemia, dyslipidemia, psoriasis, aged and UV skin wrinkling, diabetes, cancer, Alzheimer's disease, inflammation, immunological disorders, lipid disorders, obesity, macular degeneration, conditions characterized by a perturbed epidermal barrier function, conditions of disturbed differentiation or excess proliferation of the epidermis or mucous membrane, or cardiovascular disorders in a subject in need thereof.
  • Nuclear receptor refers to a receptor that activates or represses transcription of one or more genes in the nucleus (but can also have second messenger signaling actions), typically in conjunction with other transcription factors.
  • the nuclear receptor is activated by the natural cognate ligand for the receptor.
  • Nuclear receptors are ordinarily found in the cytoplasm or nucleus, rather than being membrane-bound.
  • a nuclear receptor is a member of a superfamily of regulatory proteins that are receptors for various endogenous small molecules, e.g ., steroids, retinoids, vitamin D and thyroid hormones. These proteins bind to cis-acting elements in the promoters of their target genes and modulate gene expression in response to a ligand therefore.
  • Nuclear receptors may be classified based on their DNA binding properties.
  • the glucocorticoid, estrogen, androgen, progestin and mineralocorticoid receptors bind as homodimers to hormone response elements (HREs) organized as inverted repeats.
  • HREs hormone response elements
  • receptors including those activated by retinoic acid, thyroid hormone, vitamin D 3 , fatty acids/peroxisome proliferators and ecdysone, that bind to HREs as heterodimers with a common partner, the retinoid X receptor (RXR).
  • RXR retinoid X receptor
  • LXR retinoid X receptor
  • Liver X receptor or “LXR” refers to a nuclear receptor implicated in cholesterol biosynthesis.
  • LXR refers to both LXR ⁇ and LXR ⁇ , two forms of the protein found in mammals.
  • Liver X receptor- ⁇ or LXR ⁇ refers to the receptor described in U.S. Patent Nos. 5,571,696 , 5,696,233 and 5,710,004 , and Willy et al., Genes Dev., 9(9):1033-1045 (1995 ).
  • Liver X receptor- ⁇ or LXR ⁇ refers to the receptor described in Peet et al., Curr. Opin. Genet.
  • the compounds of the present invention may form salts, preferably di-(2-amino-2-(hydroxymethyl)propanediol) ethanolate salts, which are also within the scope of this invention.
  • Reference to a compound of the present invention herein is understood to include reference to salts thereof, unless otherwise indicated.
  • the term "salt(s)", as employed herein, denotes acidic and/or basic salts formed with inorganic and/or organic acids and bases.
  • Pharmaceutically acceptable (i.e., non-toxic, physiologically acceptable) salts are preferred, although other salts are also useful, e.g ., in isolation or purification steps which may be employed during preparation.
  • Salts of the compounds of the present invention may be formed, for example, by reacting a compound with an amount of acid or base, such as an equivalent amount, in a medium such as one in which the salt precipitates or in an aqueous medium followed by lyophilization.
  • Exemplary salts include acetates (such as those formed with acetic acid or trihaloacetic acid, for example, trifluoroacetic acid), adipates, alginates, ascorbates, aspartates, benzoates, benzenesulfonates, bisulfates, borates, butyrates, citrates, camphorates, camphorsulfonates, cyclopentanepropionates, digluconates, dodecylsulfates, ethanesulfonates, fumarates, glucoheptanoates, glycerophosphates, hemisulfates, heptanoates, hexanoates, hydrochlorides (formed with hydrochloric acid), hydrobromides (formed with hydrogen bromide), hydroiodides, 2-hydroxyethanesulfonates, lactates, maleates (formed with maleic acid), methanesulfonates (formed with methanesulfonic acid
  • exemplary salts include ammonium salts, alkali metal salts such as sodium, lithium, and potassium salts, alkaline earth metal salts such as calcium and magnesium salts, salts with organic bases (for example, organic amines) such as benzathines, dicyclohexylamines, hydrabamines (formed with N,N-bis(dehydroabietyl)ethylenediamine), N-methyl-D-glucamines, N-methyl-D-glucamides, t -butyl amines, and salts with amino acids such as arginine, lysine and the like.
  • organic bases for example, organic amines
  • organic amines such as benzathines, dicyclohexylamines, hydrabamines (formed with N,N-bis(dehydroabietyl)ethylenediamine), N-methyl-D-glucamines, N-methyl-D-glucamides, t -butyl amines, and salts with amino
  • “Therapeutically effective amount” refers to that amount of a compound which, when administered to a subject, is sufficient to effect treatment for a disease or disorder described herein.
  • the amount of a compound which constitutes a “therapeutically effective amount” will vary depending on the compound, the disorder and its severity, and the age of the subject to be treated, but can be determined routinely by one of ordinary skill in the art.
  • Modulating or modulate refers to the treating, prevention, suppression, enhancement or induction of a function, condition or disorder.
  • the compounds of the present invention can modulate atherosclerosis by stimulating the removal of cholesterol from atherosclerotic lesions in a human.
  • Treating covers the treatment of a disease or disorder described herein, in a subject, preferably a human, and includes:
  • Subject refers to a warm blooded animal such as a mammal, preferably a human, or a human child, which is afflicted with, or has the potential to be afflicted with one or more diseases and disorders described herein.
  • Atherosclerosis refers to a process whereby atherosclerotic plaques form within the inner lining of the artery wall leading to atherosclerotic cardiovascular diseases.
  • Atherosclerotic cardiovascular diseases can be recognized and understood by physicians practicing in the relevant fields of medicine, and include without limitation, restenosis, coronary heart disease (also known as coronary artery disease or ischemic heart disease), cerebrovascular disease including ischemic stroke, multi-infarct dementia, and peripheral vessel disease, including intermittent claudication, and erectile dysfunction.
  • “Dyslipidemia” refers to abnormal levels of lipoproteins in blood plasma including both depressed and/or elevated levels of lipoproteins (e.g ., elevated levels of Low Density Lipoprotein, (LDL), Very Low Density Lipoprotein (VLDL) and depressed levels of High Density Lipoprotein (HDL).
  • LDL Low Density Lipoprotein
  • VLDL Very Low Density Lipoprotein
  • HDL High Density Lipoprotein
  • Cholesterol refers to a steroid alcohol that is an essential component of cell membranes and myelin sheaths and, as used herein, incorporates its common usage. Cholesterol also serves as a precursor for steroid hormones and bile acids.
  • Triglyceride(s) or “TGs” refers to three fatty acid molecules esterified to a glycerol molecule and serve to store fatty acids which are used by muscle cells for energy production or are taken up and stored in adipose tissue.
  • LXR or “LXRs” refers to both LXR ⁇ and LXR ⁇ .
  • LXR ⁇ refers to all mammalian forms of such receptor including, for example, alternative splice isoforms and naturally occurring isoforms.
  • Representative LXR ⁇ species include, without limitation the rat (GENBANK® Accession No. NM_031627), mouse (GENBANK® Accession No. BC012646), and human (GENBANK® Accession No. U22662) forms of the receptor.
  • LXR ⁇ refers to all mammalian forms of such receptor including, for example, alternative splice isoforms and naturally occurring isoforms.
  • Representative LXR ⁇ species include, without limitation the rat (GENBANK® Accession No. NM_031626), mouse (GENBANK® Accession No. NM_009473), and human (GENBANK® Accession No. U07132) forms of the receptor.
  • Bese and “obesity” refer to a Body Mass Index (BMI) greater than 27.8 kg/m 2 for men and 27.3 kg/m 2 for women (BMI equals weight (kg)/(height) 2 (m 2 ).
  • compounds of the present invention are, subsequent to their preparation, may be isolated and purified to obtain a composition containing an amount by weight equal to or greater than 99% of the compound ("substantially pure” compound), which is then used or formulated as described herein. Such “substantially pure” compounds of the present invention are also contemplated herein as part of the present invention.
  • All stereoisomers of the present compounds such as those which may exist due to asymmetric carbons on the various substituents, including enantiomeric forms (which may exist even in the absence of asymmetric carbons) and diastereomeric forms, are contemplated within the scope of this invention.
  • Individual stereoisomers of the compounds of the invention may, for example, be substantially free of other isomers, or may be admixed, for example, as racemates or with all other, or other selected, stereoisomers.
  • the present invention comprises a compound, isotope, or pharmaceutically acceptable salt thereof, selected from: and
  • the present invention comprises a compound, isotope, or pharmaceutically acceptable salt thereof, which is
  • the present invention comprises a compound, isotope, or pharmaceutically acceptable salt thereof, which is
  • the present invention comprises a pharmaceutically acceptable salt, preferably, a di-(2-amino-2-(hydroxymethyl)propanediol) ethanolate salt, of a compound of the present invention.
  • compounds of the present invention preferably, a compound selected from Examples 1, 3, and 4, and Forms E-1 and H-1, are, subsequent to their preparation, preferably isolated and purified to obtain a composition containing an amount by weight equal to or greater than 99% of said compound ("substantially pure” compound), which is then used or formulated as described herein.
  • substantially pure compounds of the present invention preferably Examples 1,3, and 4, and Forms E-1 and H-1, are also contemplated herein as part of the present invention.
  • All stereoisomers of the compounds of the instant invention are contemplated, either in admixture or in pure or substantially pure form.
  • the compounds of the present invention can have asymmetric centers at any of the sulfur or carbon atoms including any one of the R substituents and/or exhibit polymorphism. Consequently, compounds of the present invention can exist in enantiomeric, or diastereomeric forms, or in mixtures thereof.
  • the processes for preparation can utilize racemates, enantiomers, or diastereomers as starting materials. When diastereomeric or enantiomeric products are prepared, they can be separated by conventional methods for example, chromatographic or fractional crystallization.
  • the invention also includes isotopically-labeled compounds of the invention, wherein one or more atoms is replaced by an atom having the same atomic number, but an atomic mass or mass number different from the atomic mass or mass number usually found in nature.
  • isotopes suitable for inclusion in the compounds of the invention include isotopes of hydrogen, such as 2 H and 3 H, carbon such as 11 C, 13 C, and 14 C, chlorine, such as 36 Cl, fluorine such as 18 F, iodine, such as 123 I and 125 I, nitrogen, such as 13 N and 15 N, oxygen, such as 15 O, 17 O, and 18 O, phosphorus, such as 32 P, and sulfur, such as 35 S.
  • Certain isotopically-labeled compounds of the invention are useful in drug and/or substrate tissue distribution studies.
  • the radioactive isotopes tritium, 3 H, and carbon-14, 14 C are particularly useful for this purpose in view of their ease of incorporation and ready means of detection.
  • Substitution with heavier isotopes such as deuterium, 2 H may afford certain therapeutic advantages resulting from greater metabolic stability, for example, increase in vivo half-life or reduced dosage requirements, and hence may be preferred in some circumstances.
  • Substitution with positron emitting isotopes, such as 11 C, 18 F, 15 O, and 13 N can be useful in Positron Emission Topography (PET) studies for examining substrate receptor occupancy.
  • PET Positron Emission Topography
  • Isotopically-labeled compounds of the invention can generally be prepared by conventional techniques known to those skilled in the art or by processes analogous to those described herein, using an appropriate isotopically-labeled reagent in place of the non-labeled reagent otherwise employed.
  • Solid compound and “stable structure” are meant to indicate a compound that is sufficiently robust to survive isolation to a useful degree of purity from a reaction mixture, and formulation into an efficacious therapeutic agent.
  • the present invention is intended to embody stable compounds.
  • solvate refers to a crystalline form of a molecule, atom, and/or ions that further contains molecules of a solvent or solvents incorporated into the crystalline structure.
  • the solvent molecules in the solvate may be present in a regular arrangement and/or a non-ordered arrangement.
  • the solvate may comprise either a stoichiometric or nonstoichiometric amount of the solvent molecules.
  • a solvate with a nonstoichiometric amount of solvent molecules may result from partial loss of solvent from the solvate.
  • the present invention provides, at least in part, crystalline forms of the free acid of (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H- imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate, as a novel material, in particular in a pharmaceutically acceptable form.
  • crystalline forms of the free acid are in substantially pure form.
  • Preferred embodiments of crystalline forms of the free acid are disclosed as the di-(2-amino-2-(hydroxymethyl)propanediol) ethanolate salt or E-1 Form and the H-1 Form, respectively.
  • polymorph refers to crystalline forms having the same chemical composition but different spatial arrangements of the molecules, atoms, and/or ions forming the crystal.
  • amorphous refers to a solid form of a molecule, atom, and/or ions that is not crystalline. An amorphous solid does not display a definitive X-ray diffraction pattern.
  • Samples of the crystalline forms may be provided with substantially pure phase homogeneity, indicating the presence of a dominant amount of a single crystalline form and optionally minor amounts of one or more other crystalline forms.
  • the presence of more than one crystalline form in a sample may be determined by techniques such as powder X-ray diffraction (PXRD) or solid state nuclear magnetic resonance spectroscopy (ssNMR). For example, the presence of extra peaks in the comparison of an experimentally measured PXRD pattern with a simulated PXRD pattern may indicate more than one crystalline form in the sample.
  • the simulated PXRD may be calculated from single crystal X-ray data.
  • the crystalline form has substantially pure phase homogeneity as indicated by less than 10%, preferably less than 5%, and more preferably less than 2% of the total peak area in the experimentally measured PXRD pattern arising from the extra peaks that are absent from the simulated PXRD pattern.
  • the crystalline forms may be prepared by a variety of methods, including for example, crystallization or recrystallization from a suitable solvent, sublimation, growth from a melt, solid state transformation from another phase, crystallization from a supercritical fluid, and jet spraying.
  • Techniques for crystallization or recrystallization of crystalline forms from a solvent mixture include, for example, evaporation of the solvent, decreasing the temperature of the solvent mixture, crystal seeding a supersaturated solvent mixture of the molecule and/or salt, freeze drying the solvent mixture, and addition of antisolvents (countersolvents) to the solvent mixture.
  • procedures for converting the crystalline forms for example, the di-(2-amino-2-(hydroxymethyl)propanediol) ethanolate salt, back to the free acid are known to one skilled in the art.
  • the forms may be characterized and distinguished using single crystal X-ray diffraction, which is based on unit cell and intensity measurements of a single crystal of a form at a fixed analytical temperature.
  • unit cell and intensity analysis is provided in Stout et al., Chapter 3, X-Ray Structure Determination: A Practical Guide, Macmillan Co., New York (1968 ).
  • the unique arrangement of atoms in spatial relation within the crystalline lattice may be characterized according to the observed fractional atomic coordinates. See Stout et al. reference for experimental determination of fractional coordinates for structural analysis.
  • Another means of characterizing the crystalline structure is by powder X-ray diffraction analysis in which the experimental or observed diffraction profile is compared to a simulated profile representing pure powder material, both at the same analytical temperature, and measurements for the subject form characterized as a series of 2 ⁇ values and intensities.
  • a crystalline form of (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate is provided in substantially pure form.
  • This crystalline form may be employed in pharmaceutical compositions which may optionally include one or more other components selected, for example, from the group consisting of excipients, carriers, and one of other active pharmaceutical ingredients or active chemical entities of different molecular structures.
  • the crystalline form has substantially pure phase homogeneity as indicated by less than 10%, preferably less than 5%, and more preferably less than 2% of the total peak area in the experimentally measured PXRD pattern arising from the extra peaks that are absent from the simulated PXRD pattern.
  • a composition consisting essentially of the crystalline forms of (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate.
  • the composition of this embodiment may comprise at least 90 weight % of the form, based on its weight in the composition.
  • reaction impurities and/or processing impurities may be determined by analytical techniques known in the art, such as, for example, chromatography, nuclear magnetic resonance spectroscopy, mass spectrometry or infrared spectroscopy.
  • Crystalline forms may be prepared by a variety of methods, including for example, crystallization or recrystallization from a suitable solvent, sublimation, growth from a melt, solid state transformation from another phase, crystallization from a supercritical fluid, and jet spraying.
  • Techniques for crystallization or recrystallization of crystalline forms from a solvent mixture include, for example, evaporation of the solvent, decreasing the temperature of the solvent mixture, crystal seeding a supersaturated solvent mixture of the molecule and/or salt, freeze drying the solvent mixture, and addition of antisolvents (countersolvents) to the solvent mixture.
  • High throughput crystallization techniques may be employed to prepare crystalline forms including polymorphs.
  • Crystals of drugs including polymorphs, methods of preparation, and characterization of drug crystals are discussed in Byrn, S.R. et al., Solid-State Chemistry of Drugs, 2nd Edition, SSCI, West Lafayette, Indiana (1999 ).
  • solvent for crystallization techniques that employ solvent, the choice of solvent or solvents is typically dependent upon one or more factors, such as solubility of the compound, crystallization technique, and vapor pressure of the solvent. Combinations of solvents may be employed; for example, the compound may be solubilized into a first solvent to afford a solution, followed by the addition of an antisolvent to decrease the solubility of the compound in the solution and to afford the formation of crystals.
  • An "antisolvent" is a solvent in which the compound has low solubility.
  • Suitable solvents for preparing crystals include polar and nonpolar solvents.
  • slurry means a saturated solution of the free acid, which may also contain an additional amount of the compound to afford a heterogeneous mixture of the compound and a solvent at a given temperature.
  • suitable solvents include, for example, polar aprotic solvents and polar protic solvents, and mixtures of two or more of these, as disclosed herein.
  • Seed crystals may be added to any crystallization mixture to promote crystallization.
  • seeding is used as a means of controlling growth of a particular crystalline form or as a means of controlling the particle size distribution of the crystalline product. Accordingly, calculation of the amount of seeds needed depends on the size of the seed available and the desired size of an average product particle as described, for example, in Mullin, J.W. et al., "Programmed cooling of batch crystallizers", Chemical Engineering Science, 26:369-377 (1971 ).
  • seeds of small size are needed to effectively control the growth of crystals in the batch. Seeds of small size may be generated by sieving, milling, or micronizing of larger crystals, or by micro-crystallization of solutions. Care should be taken that milling or micronizing of crystals does not result in any change in crystallinity from the desired crystal form (i.e., change to amorphous or to another polymorph).
  • a cooled mixture may be filtered under vacuum, and the isolated solids may be washed with a suitable solvent, such as cold recrystallization solvent, and dried under a nitrogen purge to afford the desired crystalline form.
  • the isolated solids may be analyzed by a suitable spectroscopic or analytical technique, such as SSNMR, DSC, PXRD, or the like, to assure formation of the preferred crystalline form of the product.
  • the resulting crystalline form is typically produced in an amount of greater than about 70 weight % isolated yield, but preferably greater than 90 weight % based on the weight of (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate originally employed in the crystallization procedure.
  • the product may be co-milled or passed through a mesh screen to de-lump the product, if necessary.
  • Crystalline forms may be prepared directly from the reaction medium of the final process step for preparing (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate.
  • This may be achieved, for example, by employing in the final process step a solvent or mixture of solvents from which the free acid may be crystallized.
  • crystalline forms may be obtained by distillation or solvent addition techniques.
  • Suitable solvents for this purpose include any of those solvents described herein, including protic polar solvents, such as alcohols, and aprotic polar solvents, such as ketones.
  • the reaction mixture may be filtered to remove any undesired impurities, inorganic salts, and the like, followed by washing with reaction or crystallization solvent.
  • the resulting solution may be concentrated to remove excess solvent or gaseous constituents. If distillation is employed, the ultimate amount of distillate collected may vary, depending on process factors including, for example, vessel size, stirring capability, and the like.
  • the reaction solution may be distilled to about 1/10 the original volume before solvent replacement is carried out.
  • the reaction may be sampled and assayed to determine the extent of the reaction and the wt % product in accordance with standard process techniques. If desired, additional reaction solvent may be added or removed to optimize reaction concentration.
  • the final concentration is adjusted to about 50 wt % at which point a slurry typically results. It may be preferable to add solvents directly to the reaction vessel without distilling the reaction mixture. Preferred solvents for this purpose are those which may ultimately participate in the crystalline lattice, as discussed above in connection with solvent exchange. Although the final concentration may vary depending on desired purity, recovery and the like, the final concentration of the free acid in solution is preferably about 4% to about 7%.
  • the reaction mixture may be stirred following solvent addition and simultaneously warmed. By way of illustration, the reaction mixture may be stirred for about 1 hour while warming to about 70 °C.
  • the reaction is preferably filtered hot and washed with either the reaction solvent, the solvent added or a combination thereof.
  • Seed crystals may be added to any crystallization solution to initiate crystallization.
  • the various forms described herein may be distinguishable from one another through the use of various analytical techniques known to one of ordinary skill in the art. Such techniques include, but are not limited to, X-ray powder diffraction (PXRD). Specifically, the forms may be characterized and distinguished using single crystal x-ray diffraction, which is based on unit cell measurements of a single crystal of a given form at a fixed analytical temperature. A detailed description of unit cells is provided in Stout et al., Chapter 3, X-Ray Structure Determination: A Practical Guide, Macmillan Co., New York (1968 ).
  • the unique arrangement of atoms in spatial relation within the crystalline lattice may be characterized according to the observed fractional atomic coordinates.
  • Another means of characterizing the crystalline structure is by powder x-ray diffraction analysis in which the diffraction profile is compared to a simulated profile representing pure powder material, both run at the same analytical temperature, and measurements for the subject form characterized as a series of 2 ⁇ values (usually four or more).
  • ssNMR solid state nuclear magnetic resonance
  • DSC differential scanning calorimetry
  • TGA thermogravimetric analysis
  • an X-ray diffraction pattern may be obtained with a measurement error that is dependent upon the measurement conditions employed.
  • intensities in an X-ray diffraction pattern may fluctuate depending upon measurement conditions employed and the shape or morphology of the crystal.
  • relative intensities may also vary depending upon experimental conditions and, accordingly, the exact order of intensity should not be taken into account.
  • a measurement error of diffraction angle for a conventional X-ray diffraction pattern is typically about 0.2° or less, preferably about 0.1° (as discussed hereinafter), and such degree of measurement error should be taken into account as pertaining to the aforementioned diffraction angles.
  • crystal forms of the instant invention are not limited to the crystal forms that provide X-ray diffraction patterns completely identical to the X-ray diffraction patterns depicted in the accompanying Figures disclosed herein. Any crystal forms that provide X- ray diffraction patterns substantially identical to those disclosed in the accompanying Figures fall within the scope of the present invention.
  • the ability to ascertain substantial identities of X-ray diffraction patterns is within the purview of one of ordinary skill in the art.
  • Step 1 Synthesis of di- tert -butyl (4'-(2-(2-(2,6-dichlorophenyl)propan-2-yl)-4-(2-hydroxypropan-2-yl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl phosphate
  • a hexanes and ethyl acetate (1:1) solvent mixture containing 1.5% of triethylamine was used instead of CH 2 Cl 2 and the yield of di- tert- butyl (4'-(2-(2-(2,6-dichlorophenyl)propan-2-yl)-4-(2-hydroxypropan-2-yl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl phosphate was improved to 47% yield.
  • Example 1 (3.5 g) as white crystals.
  • HPLC UV Waters Acquity BEH C18; 1.7 ⁇ m; 150 X 2.1 mm ID at 35 °C; Solvent A: 30 mM ammonium bicarbonate in H 2 O pH 9.5; Solvent B: MeCN; 0.35 mL/min; gradient: hold 10% B for 0 - 1 min, 10 - 35% B for 1 - 25 min, 35 - 98% B for 25 - 32 min, hold 98% B for 32-35 min, 98 - 10% B for 35.0-35.3 min, hold 10% B for 35.3 - 40 min; UV detection: 260nm) purity was 99.44%. Using 1 H-NMR, NH 4 OAc; was estimated to be approximately one equivalent.
  • Example 2 (2.7 g, 3.4 mmol, 47% yield, UV purity: 99.7%) as a white solid. Residual solvent analysis indicated the sample contained diethylamine (10.3% weight/weight), acetone (0.9% weight/weight), and dimethylformamide (0.03% weight/weight).
  • the resulting mixture was rinsed with acetonitrile and then stirred for one hour. After this time, the reaction was analyzed by HPLC, which indicated the reaction was complete.
  • the reaction mixture was quenched by an inverse addition into a pre-cooled (0 to -5 °C) solution of water (5 kg) and acetonitrile (0.98 kg). Upon completion of addition, the reaction vessel was rinsed with acetonitrile (0.405 kg) and then transferred to the quench vessel. To the quenched reaction mixture was added a potassium phosphate solution (potassium phosphate tribasic, 0.696 kg in water 2.09 kg) such that the temperature was maintained below 20 °C.
  • the wet cake was added to the aqueous solution of 2-amino-2(hydroxymethyl)-1,3-propanediol and a mild exotherm to 23 °C was observed.
  • Acetonitrile (3.52 kg) was added resulting in an endotherm to 15 °C.
  • the solution was polish filtered from the first reactor into a second reactor and the first reactor was rinsed with a solution of water (0.55 kg) and acetonitrile (0.88 kg) to complete the transfer.
  • This wet cake was added to a clean first reactor containing water (2 kg) at 40 °C and then stirred at 40 °C until a solution was obtained.
  • the resulting solution was polish filtered from this reactor into a second reactor and the first reactor was rinsed with water (0.4 kg) to complete the transfer.
  • Ethanol (12.1 kg) was added to the solution such that the temperature was 40-50 °C.
  • the resulting solution was seeded with a slurry of Example 3 (3.8 g, 4.08 mmol) in ethanol (38 mL) which resulted in a thin slurry.
  • the thin slurry was stirred for 15 min and then cooled over a two hour period to 0 °C where it stirred for 30 min.
  • Example 3 as a white solid (0.63 kg, 85% yield, 99.67 area %, 4.28 wt% EtOH and 0.12 wt% water).
  • Example 3 (4'-(2-(2-(2,6-dichlorophenyl)propan-2-yl)-4-(2-hydroxypropan-2-yl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate with 2-amino-2-(hydroxymethyl)propane-1,3-diol and ethanol, Example 3 can be used to prepare (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate, Example 1, as follows:
  • the solution was polish filtered through Whatman #1 filter paper into a 500-mL reactor and the filtrate was heated to 60 °C.
  • the pH was slowly adjusted to pH 2 (targeting 3) with 1 M H 3 PO 4 (35 mL).
  • the mixture was heated to 60 °C, where it stirred for 1 h. After this time, the mixture was cooled to 20 °C during a 2 h period. Once at the prescribed temperature, the mixture was stirred for at least 1 h. After this time, the resulting slurry was filtered and the wet cake was washed with water (120 mL). The wet cake was dried at 60 °C/25 in Hg over night to afford Example 1 (10.66 g, 97% yield, 98.88 Area %).
  • Step 2 2-(4-(Bis(bezyloxy)phosphoryloxy)phenyl) acetic acid
  • Step 3 Synthesis of (4'-(2-(2-(2,6-dichlorophenyl)propan-2-yl)-4-(2-hydroxypropan-2-yl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl 2-(4-(bis(benzyloxy)phosphoryloxy)phenyl)acetate
  • Crystal forms of (4'-(2-(1-(2,6-dichlorophenyl)-1-methylethyl)-4-(1-hydroxy-1-methylethyl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate, free acid were characterized as described below.
  • X-ray powder diffraction (PXRD) data were obtained using a Bruker C2 GADDS.
  • the radiation was CuK ⁇ (40 KV, 40mA).
  • the sample-detector distance was 15 cm.
  • Powder samples were placed in sealed glass capillaries of 1mm or less in diameter; the capillary was rotated during data collection. Data were collected for 3 ⁇ 2 ⁇ 35° with a sample exposure time of at least 1000 seconds.
  • the resulting two-dimensional diffraction arcs were integrated to create a traditional 1-dimensional PXRD pattern with a step size of 0.02 degrees 2 ⁇ in the range of 3 to 35 degrees 2 ⁇ . 1 Otwinowski, Z.
  • DSC Differential scanning calorimetry
  • TGA Thermal gravimetric analysis
  • the unit cell data and other properties for Form H-1 of the present invention are presented in Table 1.
  • the unit cell parameters were obtained from single crystal X-ray crystallographic analysis. A detailed account of unit cells can be found in Chapter 3 of Stout et al., X-Ray Structure Determination: a Practical Guide, Macmillan (1968 ).
  • Form H-1 (4'-(2-(2-(2,6-dichlorophenyl)propan-2-yl)-4-(2-hydroxypropan-2-yl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate.
  • Form H-1 free acid was characterized by an experimental PXRD pattern which matches the simulated pattern generated from the single crystal structure data.
  • Figures 2 and 3 present PXRD patterns for Forms E-1 and H-1, respectively.
  • Figure 4 discloses the DSC of Form E-1.
  • Figure 5 discloses the TGA of Form E-1.
  • Figure 6 discloses a moisture-sorption isotherm analysis of Form H-1.
  • Figures 7 and 8 disclose the 13 C CPMAS ssNMR spectra of Forms E-1 and H-1, respectively.
  • Figure 9 discloses the 19 F ssNMR spectrum of Form E-1.
  • Form E-1 (4'-(2-(2-(2,6-dichlorophenyl)propan-2-yl)-4-(2-hydroxypropan-2-yl)-1 H -imidazol-1-yl)-3,3'-difluoro-5-(methylsulfonyl)biphenyl-4-yl)methyl dihydrogen phosphate with 2-amino-2-(hydroxymethyl)propane-1,3-diol and ethanol (di-(2-amino-2-(hydroxymethyl)propanediol) ethanolate salt).
  • Form E-1 was characterized by a DSC thermogram having an endothermic event typically at ca. 166 °C, at higher temperatures other events may ensue.
  • Form E-1 was characterized by a TGA curve having negligible weight loss at up to ca. 100 °C.
  • the compounds of the invention exhibit valuable pharmacological properties.
  • the compounds of the invention are useful for the treatment of diseases or disorders described herein, such as those associated with, or having symptoms arising from the complications of, altered cholesterol transport, reverse cholesterol transport, fatty acid metabolism, cholesterol absorption, cholesterol reabsorption, cholesterol secretion, cholesterol excretion, or cholesterol metabolism.
  • diseases include, for example, atherosclerosis, atherosclerotic cardiovascular diseases, (see, e.g., PCT Publication Nos. WO 00/57915 and WO 00/37077 ), dyslipidemia, hyperglycemia, insulin resistance, diabetes, obesity, syndrome X ( U.S. Patent Application Publication No.
  • Pathol., 151:1371-1377 (1997 )), or Alzheimer's disease see, e.g., PCT Publication No. WO 00/17334 ; Trends in Neurosciences, 17:525-530 (1994 )), prevention of degenerative neuropathies occurring in diseases such as diabetic neuropathies (see, e.g., PCT Publication No. WO 01/82917 ), multiple sclerosis ( Ann. Clin. Biochem., 33(2):148-150 (1996 )), and autoimmune diseases ( J. Lipid Res., 39:1740-1743 (1998 )).
  • ABCA1 ATP-Binding Cassette
  • the invention also includes a compound of the invention, preferably Examples 1,3, and 4, and Forms E-1 and H-1, or a composition comprising a compound of the invention, preferably Examples 1, 3, and 4, and Forms E-1 and H-1, for use in removing cholesterol from tissue deposits such as atherosclerotic plaques or xanthomas in a subject with atherosclerosis or atherosclerotic cardiovascular disease manifest by clinical signs of such disease.
  • the instant invention also provides a compound, preferably Examples 1,3, and 4, and Forms E-1 and H-1, or a composition comprising a compound, preferably Examples 1,3, and 4, and Forms E-1 and H-1, of the present invention for use in preventing or reducing the risk of a first or subsequent occurrence of an atherosclerotic cardiovascular disease event including ischemic heart disease, ischemic stroke, multi-infarct dementia, and intermittent claudication.
  • an atherosclerotic cardiovascular disease event including ischemic heart disease, ischemic stroke, multi-infarct dementia, and intermittent claudication.
  • the compounds of the present invention are also suitable for use in decreasing hyperglycemia and insulin resistance, i.e., for use in treating diabetes ( PCT Publication No. WO 01/82917 ), and for use in the treatment, prevention, or amelioration of disorders related to, or arising as complications of diabetes, hyperglycemia or insulin resistance including the cluster of disease states, conditions or disorders that make up "Syndrome X" (See U.S. Patent Application Publication No. 2003/0073614 ). Additionally, the instant invention also provides a compound or composition of the present invention for use in preventing or reducing the risk of developing hyperglycemia, insulin resistance, diabetes or syndrome X in a subject.
  • Diabetes mellitus commonly called diabetes, refers to a disease process derived from multiple causative factors and characterized by elevated levels of plasma glucose, referred to as hyperglycemia.
  • hyperglycemia a disease process derived from multiple causative factors and characterized by elevated levels of plasma glucose, referred to as hyperglycemia.
  • Uncontrolled hyperglycemia is associated with increased and premature mortality due to an increased risk for macrovascular diseases, including nephropathy, neuropathy, retinopathy, hypertension, cerebrovascular disease and coronary heart disease. Therefore, control of glucose homeostasis is a critically important approach for the treatment of diabetes.
  • Type 1 diabetes (formerly referred to as insulin-dependent diabetes or IDEM); and type 2 diabetes (formerly referred to as noninsulin dependent diabetes or NIDDM).
  • IDEM insulin-dependent diabetes
  • NIDDM noninsulin dependent diabetes
  • Type 2 diabetes is a disease characterized by insulin resistance accompanied by relative, rather than absolute, insulin deficiency. Type 2 diabetes can range from predominant insulin resistance with relative insulin deficiency to predominant insulin deficiency with some insulin resistance. Insulin resistance is the diminished ability of insulin to exert its biological action across a broad range of concentrations. In insulin resistant individuals, the body secretes abnormally high amounts of insulin to compensate for this defect. When inadequate amounts of insulin are present to compensate for insulin resistance and adequate control of glucose, a state of impaired glucose tolerance develops.
  • Type 2 diabetes can be due to a profound resistance to insulin stimulating regulatory effects on glucose and lipid metabolism in the main insulin-sensitive tissues: muscle, liver and adipose tissue. This resistance to insulin responsiveness results in insufficient insulin activation of glucose uptake, oxidation and storage in muscle and inadequate insulin repression of lipolysis in adipose tissue and of glucose production and secretion in liver.
  • free fatty acid levels are often elevated in obese and some non-obese subjects and lipid oxidation is increased.
  • Hyperlipidemia is an important precipitating factor for these diseases.
  • Hyperlipidemia is a disorder generally characterized by an abnormal increase in serum lipids, e.g., cholesterol and triglyceride, in the bloodstream and is an important risk factor in developing atherosclerosis and heart disease.
  • serum lipids e.g., cholesterol and triglyceride
  • lipid metabolism see, e.g., Wilson, J. et al., eds., Chapter 23: "Disorders of Lipid Metabolism", Textbook of Endocrinology, 9th Edition, W.B. Sanders Company, Philadelphia, PA, USA (1998 ).
  • Hyperlipidemia is usually classified as primary or secondary hyperlipidemia.
  • Primary hyperlipidemia is generally caused by genetic defects, while secondary hyperlipidemia is generally caused by other factors, such as various disease states, drugs, and dietary factors.
  • hyperlipidemia can result from both a combination of primary and secondary causes of hyperlipidemia.
  • Elevated cholesterol levels are associated with a number of disease states, including coronary artery disease, angina pectoris, carotid artery disease, strokes, cerebral arteriosclerosis, and xanthoma.
  • the compounds of the invention preferably Examples 1,3, and 4, and Forms E-1 and H-1, for use in treating obesity, as well as the complications of obesity.
  • Obesity is linked to a variety of medical disorders including diabetes and hyperlipidemia. Obesity is also a known risk factor for the development of type 2 diabetes ( See , e.g., Barrett-Conner, E., Epidernaol. Rev., 11:172-181 (1989 ); and Knowler, et al., Am. J. Clin. Nutr., 53:1543-1551 (1991 )).
  • Compounds within the scope of the present invention alter nuclear receptor activity, including LXR and/or orphan nuclear receptor activity, and as such are useful in the treatment, prevention, or amelioration of one or more symptoms of diseases or disorder that are modulated by nuclear receptor activity, including LXR and/or orphan nuclear receptor activity, or in which nuclear receptor activity, including LXR and/or orphan nuclear receptor activity, is implicated.
  • the present invention thus provides at least one compound of the present invention, preferably Examples 1, 3 and 4 for use in the prevention or treatment of one or more of the aforementioned disorders.
  • Other therapeutic agents such as those described below may be employed with the inventive compounds, preferably Examples 1,3, and 4, and Forms E-1 and H-1, in the present methods.
  • Such other therapeutic agent(s) may be administered prior to, simultaneously with or following the administration of the compound(s) of the present invention.
  • Standard physiological, pharmacological and biochemical procedures are available for testing the compounds to identify those that possess biological activities that modulate the activity of the LXRs (LXR ⁇ and LXR ⁇ ).
  • assays include, for example, biochemical assays such as binding assays, fluorescence polarization assays, FRET-based coactivator recruitment assays (see , generally, Glickman et al., J. Biomolecular Screening, 7(1):3-10 (2002 )), as well as cell based assays including the co-transfection assay, the use of LBD-Gal 4 chimeras and protein-protein interaction assays, ( see , Lehmann et al., J. Biol. Chem., 272(6):3137-3140 (1997 )).
  • the compounds were administered by oral gavage at 1 mg/kg (1 mg/mL) in 90% PEG 400/10% Ethanol (as a solution) or in 0.5% carboxyl methylcellulose in capsule (as a suspension) to pentagastrin-pretreated dogs.
  • the effect of pH on the oral bioavailability was investigated by administering a compound of the present invention (0.1 or 1 mg/kg) as a suspension dose in capsule to the same dogs after famotidine pretreatment.
  • Serial blood samples were collected by direct jugular venipuncture at 0.25, 0.5, 0.75, 1, 2, 4, 6, 8, 24 and 48 hours post-dose. Plasma was prepared immediately, and the samples were frozen on dry ice.
  • the pharmacokinetic parameters of a compound of the present invention were obtained by non-compartmental analysis of plasma concentration vs. time data (KINETICA software, Version 4.2, InnaPhase Corporation, Philadelphia, PA).
  • the peak concentration (Cmax) and time for Cmax (Tmax) were recorded directly from experimental observations.
  • the area under the curve from time zero to the last sampling time (AUC(0-T)) and the area under the curve from time zero to infinity (AUC(INF)) were calculated using a combination of linear and log trapezoidal summations.
  • the total plasma clearance (CLTp), steady-state volume of distribution (Vss), apparent elimination half-life (T1/2) and mean residence time (MRT) were estimated after IV administration.
  • CLTb total blood clearance
  • F absolute oral bioavailability
  • model systems including diabetic dislipidemia using Zucker (fa/fa) rats or (db/db) mice, spontaneous hyperlipidemia using apolipoprotein E deficient mice (ApoE.sup.-/-), diet-induced hyperlipidemia, using low density lipoprotein receptor deficient mice (LDLR.sup.-/-) and atherosclerosis using both the Apo E(.sup.-/-) and LDLR(.sup.-/-) mice fed a western diet. (21% fat, 0.05% cholesterol) may be used.
  • LXR animal models e.g., knockout mice
  • LXR animal models can be used to further evaluate the present compounds and compositions in vivo (see , for example, Peet et al., Cell, 93:693-704 (1998 ), Sinal et al., Cell, 102:731-744 (2000 )).
  • compounds of the invention can be tested in mice, hamsters, rabbits or cynomolgus monkeys for peripheral blood cell ABCA1 and ABCG1 gene inductions and lipid effects.
  • the present invention also provides pharmaceutical compositions comprising at least one of the compounds of the present invention, preferably Examples 1, 3 and 4, and Forms E-1 and H-1, and the salts of such compounds capable of preventing, treating, and/or slowing the progression of one or more of the aforementioned disorders in an amount effective therefore, and a pharmaceutically acceptable vehicle or diluent.
  • the compositions of the present invention may contain other therapeutic agents as described below, and may be formulated, for example, by employing conventional solid or liquid vehicles or diluents, as well as pharmaceutical additives of a type appropriate to the mode of desired administration (for example, excipients, binders, preservatives, stabilizers, flavors, etc.) according to techniques such as those well known in the art of pharmaceutical formulation.
  • a compound of the invention can be administered to subject in need thereof by any accepted route of administration.
  • Acceptable routes of administration include, but are not limited to, buccal, cutaneous, endocervical, endosinusial, endotracheal, enteral, epidural, interstitial, intra-abdominal, intra-arterial, intrabronchial, intrabursal, intracerebral, intracisternal, intracoronary, intradermal, intraductal, intraduodenal, intradural, intraepidermal, intraesophageal, intragastric, intragingival, intraileal, intralymphatic, intramedullary, intrameningeal, intramuscular, intraovarian, intraperitoneal, intraprostatic, intrapulmonary, intrasinal, intraspinal, intrasynovial, intratesticular, intrathecal, intratubular, intratumor, intrauterine, intravascular, intravenous, nasal, nasogastric, oral, parenteral, percutaneous
  • a compound of the invention can be administered in any acceptable solid, semi-solid, liquid or gaseous dosage form.
  • Acceptable dosage forms include, but are not limited to, aerosols, capsules, creams, emulsions, gases, gels, grains, liniments, lotions, ointments, pastes, powders, solutions, suspensions, syrups and tablets.
  • Acceptable delivery systems include, but are not limited to, biodegradable implants (e.g ., poly(DL-lactide), lactide/glycolide copolymers and lactide/caprolactone copolymers), capsules, douches, enemas, inhalers, intrauterine devices, nebulizers, patches, pumps and suppositories.
  • a dosage form of the invention may be comprised solely of a compound of the invention, preferably Examples 1, 3 and 4, and Forms E-1 and H-1, or the compound of the invention may be formulated along with conventional excipients, pharmaceutical carriers, adjuvants, and/or other medicinal or pharmaceutical agents.
  • Acceptable excipients include, but are not limited to: (a) antiadherents, such as croscarmellose sodium, crosprovidone, sodium starch glycolate, microcrystalline cellulose, starch and talc; (b) binders, such as cellulose, gelatin, hydroxypropyl cellulose, lactose, maltitol, polyethylene glycol, polyvinyl pyrrolidone, sorbitol, starch, sugar, sucrose and xylitol; (c) coatings, such as cellulose, shellac, zein and enteric agents; (d) disintegrants, such as cellulose, crosslinked polyvinyl pyrrolidone, sodium carboxymethylcellulose, methylcellulose, microcrystalline cellulose, sodium starch glycolate and starch; (e) filling agents, such as calcium carbonate, cellulose, dibasic calcium phosphate, glucose, lactose, mannitol, sorbitol and sucrose; (f) flavoring agents
  • Capsules may contain any of the afore listed excipients, and may additionally contain a semi-solid or liquid carrier, such as a polyethylene glycol or vegetable-based oils.
  • Pharmaceutical carriers include soluble polymers, microparticles made of insoluble or biodegradable natural and synthetic polymers, microcapsules or microspheres, lipoproteins, liposomes and micelles.
  • the pharmaceutical composition may be in the form of a liquid, e.g. , an elixir, syrup, solution, emulsion, suspension, or other like forms or may be presented as a dry product for reconstitution with water or other suitable vehicle before use.
  • Liquid preparations may contain conventional additives such as: (a) liquid diluents, such as water, saline, Ringer's solution, fixed oils such as synthetic mono or diglycerides, or polyethylene glycols, glycerin, propylene glycol or other solvents; (b) surfactants, suspending agents, or emulsifying agents, such as polyoxyethylene sorbitan fatty acid esters, saturated polyglycolized glycerides, monoglycerides, fatty acid esters, block copolymers of ethylene oxide and propylene oxide, polyoxyl stearates, ethoxylated castor oils, and ethoxylated hydroxystearic acids; (c) buffers, such as
  • a pharmaceutical composition of the invention will contain a therapeutically effective amount of a compound of the invention, preferably Examples 1, 3, and 4, and Forms E-1 and H-1, as an individual stereoisomer or mixture of stereoisomers, or a pharmaceutically acceptable salt thereof, with the remainder of the pharmaceutical composition comprised of one or more pharmaceutically acceptable excipients.
  • a compound of the invention, as an individual stereoisomer or mixture of stereoisomers, or a pharmaceutically acceptable salt thereof will comprise from 1% to 99% by weight of a pharmaceutically acceptable composition, with the remainder of the composition comprised of one or more pharmaceutically acceptable excipients.
  • a compound of the invention as an individual stereoisomer or mixture of stereoisomers, or a pharmaceutically acceptable salt thereof will comprise from 5% to 75% by weight of a pharmaceutically acceptable composition, with the remainder of the composition comprised of one or more pharmaceutically acceptable excipients.
  • a compound of the invention, as an individual stereoisomer or mixture of stereoisomers, or a pharmaceutically acceptable salt thereof will comprise from 0.01% to 1% by weight of a pharmaceutically acceptable composition.
  • a therapeutically effective amount of a compound of the invention will vary depending upon a sundry of factors including the activity, metabolic stability, rate of excretion and duration of action of the compound, the age, weight, general health, sex, diet and species of the subject, the mode and time of administration of the compound, the presence of adjuvants or additional therapeutically active ingredients in a composition, and the severity of the disease for which the therapeutic effect is sought.
  • the compounds of the invention can be administered to human subjects at dosage levels in the range of about 0.1 to about 10,000 mg per day.
  • a normal human adult having a body weight of about 70 kilograms can be administered a dosage in the range of from about 0.15 ⁇ g to about 150 mg per kilogram of body weight per day.
  • a normal adult human will be administered from about 0.1 mg to about 25 mg, or 0.5 mg to about 10 mg per kilogram of body weight per day.
  • the compounds of the invention may be administered in one or more unit dose forms.
  • the unit doses may be administered one to four times a day, or two times a day, or once a day.
  • an oral unit dose is one that is necessary to achieve a blood serum level of about 0.02 to 20 ⁇ g/ml or about 1 to 20 ⁇ g/ml in a subject.
  • the optimum dose of a compound of the invention for a particular subject can be determined by one of ordinary skill in the art.
  • Compounds of the invention or a pharmaceutically acceptable salt thereof may also be administered simultaneously with, prior to, or after administration of one or more of the therapeutic agents described below.
  • Such combination therapy includes administration of a single pharmaceutical dosage formulation which contains a compound of the invention and one or more additional active agents, as well as administration of the compound of the invention and each active agent in its own separate pharmaceutical dosage formulation.
  • a compound of the invention and an HMG-CoA reductase inhibitor can be administered to the subject together in a single oral dosage composition such as a tablet or capsule, or each agent administered in separate oral dosage formulations.
  • the compounds of the invention and one or more additional active agents can be administered at essentially the same time, i.e., concurrently, or at separately staggered times, i.e., sequentially; combination therapy is understood to include all these regimens.
  • the compounds of the invention may be used in combination with one or more of the following therapeutic agents in treating atherosclerosis: antihyperlipidemic agents, plasma HDL-raising agents, antihypercholesterolemic agents, cholesterol biosynthesis inhibitors (such as HMG CoA reductase inhibitors, such as lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin and rivastatin), acyl-coenzyme A:cholesterol acyltransferase (ACAT) inhibitors, probucol, raloxifene, nicotinic acid, niacinamide, cholesterol absorption inhibitors, bile acid sequestrants (such as anion exchange resins, or quaternary amines (e.g., cholestyramine or colestipol)), low density lipoprotein receptor inducers, clofibrate, fenofibrate, benzofibrate, cipofibrate, gemfibri
  • the compounds of the invention may be used in combination with one or more of the following therapeutic agents in treating cholesterol biosynthesis inhibitor, particularly an HMG-CoA reductase inhibitor.
  • HMG-CoA reductase inhibitor is intended to include all pharmaceutically acceptable salt, ester, and other forms of compounds which have HMG-CoA reductase inhibitory activity and, therefore, the use of such salts, esters, and other forms is included within the scope of this invention.
  • Compounds which have inhibitory activity for HMG-CoA reductase can be readily identified using assays well-known in the art. For instance, suitable assays are described or disclosed in U.S. Patent No.
  • HMG-CoA reductase inhibitors include, but are not limited to, lovastatin (MEVACOR®; see, U.S. Patent No. 4,231,938 ); simvastatin (ZOCOR®; see, U.S. Patent No. 4,444,784 ); pravastatin sodium (PRAVACHOL®; see, U.S. Patent No. 4,346,227 ); fluvastatin sodium (LESCOL®; see, U.S. Patent No. 5,354,772 ); atorvastatin calcium (LIPITOR®; see, U.S. Patent No.
  • HMG-CoA reductase inhibitor is selected from lovastatin and simvastatin.
  • the compounds of the invention may be used in combination with one or more additional active diabetes agents depending on the desired target therapy (see , e.g., Turner, N. et al., Prog. Drug Res., 51:33-94 (1998 ); Haffner, S., Diabetes Care, 21:60-178 (1998 ); and DeFronzo, R. et al., eds., Diabetes Reviews, 5(4) (1997 )).
  • additional active diabetes agents see, e.g., Turner, N. et al., Prog. Drug Res., 51:33-94 (1998 ); Haffner, S., Diabetes Care, 21:60-178 (1998 ); and DeFronzo, R. et al., eds., Diabetes Reviews, 5(4) (1997 )).
  • a number of studies have investigated the benefits of combination therapies with oral agents ( see, e.g., Mahler, R., J. Clin. Endocrinol.
  • the compounds of the invention may be used in combination with one or more of the following therapeutic agents in treating in treating diabetes: sulfonylureas (such as chlorpropamide, tolbutamide, acetohexamide, tolazamide, glyburide, gliclazide, glynase, glimepiride, and glipizide), biguanides (such as metformin), thiazolidinediones (such as ciglitazone, pioglitazone, troglitazone, and rosiglitazone), and related insulin sensitizers, such as selective and non-selective activators of PPAR ⁇ , PPAR ⁇ and PPAR ⁇ ; dehydroepiandrosterone (also referred to as DHEA or its conjugated sulphate ester, DHEA-SO4); antiglucocorticoids; TNF ⁇ ⁇ inhibitors; ⁇ -glucos
  • sulfonylureas such as chlorprop
  • the compounds of the invention may be used in combination with one or more of the following therapeutic agents in treating obesity or obesity-related disorders.
  • agents include, but are not limited to, phenylpropanolamine, phentermine, diethylpropion, mazindol, fenfluramine, dexfenfluramine, phentiramine, ⁇ 3 adrenoceptor agonist agents; sibutramine, gastrointestinal lipase inhibitors (such as orlistat), and leptins.
  • agents used in treating obesity or obesity-related disorders include neuropeptide Y, enterostatin, cholecytokinin, bombesin, amylin, histamine H 3 receptors, dopamine D 2 receptor modulators, melanocyte stimulating hormone, corticotrophin releasing factor, galanin and gamma amino butyric acid (GABA).
  • GABA gamma amino butyric acid
  • the combinations can be co-formulated or in the form of kits packaged to provide appropriate dosages for co-administration.

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